Big Business, Big Pharma, Big Mental Health? The proliferation of Multitherapist Multiclient Web-based Platforms

Part I

This blog is a two-part series where I walk the reader through the process of signing up for and receiving services through the mental health platform, BetterHelp.com.   I will give you some background about why I did this, as well elaborate about some of the pros and cons that I noticed during my experience. Other legal and ethical issues will be explored in Part II.

Background

Many psychologists have different skill sets than those which are required to run a successful business. Perhaps because of this, many psychologists work for someone else. They may work in the public sector, in a hospital, or in a private clinic where there is someone in management who takes care of office administration. Private clinics can have just a small number of psychologists or sometimes over fifty. They may also provide valuable services including continuing education and on-site supervision.

A modern phenomenon is that of the Multitherapist Multiclient web-based platform. These platforms provide marketing, billing, and a digital interface from which to see one’s clients. In the post-Covid era, many users became accustomed to seeing their therapist online, so these platforms often do not expect their clinicians to have a physical office. Sometimes they provide more to the psychologist, such as clinician support and supervision. It is hard, as an independent psychologist, not to feel intimidated when companies such as BetterHelp (which boasts over 25,000 therapists) start marketing in your area. They used to just be a USA phenomenon but now they also provide therapy all over the world. The # 1 google search for ‘psychologist’ in Copenhagen, Denmark is betterhelp.com. One wonders if these kinds of platforms will eventually replace in-person psychologists. Their prices claim to be good, and they have the funds to out-spend smaller clinics with their marketing.

I was curious about how BetterHelp worked and wanted to take an ‘inside look.’  I am also someone who believes that therapy is good for most anyone, so I decided to sign up myself. The following information is based on my experience (which took place in May-June 2022), and some of the public information advertised on the BetterHelp.com website.

What is it like to sign up and get matched with a therapist?

I will be honest:  Sign-up with BetterHelp was one of the sleekest processes I have experienced.

Their online intake form integrates symptom questionnaires with demographics, time zone and therapist preference. It was streamlined and intuitive. Honestly, I wish I had it for our office.

As far as matching with a therapist– I am not sure why I was matched with the person I was. She was in Idaho– many time zones from Denmark and did not have any specialty that particularly suited my profile.

How is the first session?

They did not find me a therapist as quickly as they stated they would. Eventually, I received a message from BetterHelp that they could speed up the process if I would pay for my first month. This is in direct contradiction with their FAQ which state that you do not pay until you are matched (see highlighted portion):

Another problem is that the therapist I was matched with did not have any openings for three weeks. But I paid for a month so that meant that I had three weeks paid for, without services. This hardly makes it worth ones while.

BetterHelp’s customer service was, during the initial weeks, impressive:  During the therapist-matching period, I received frequent emails asking if I was okay and if the process was going smoothly. They oddly were confused about who I was, at times. For example, they did not know that I had not seen my therapist yet (I would think this information would be available to them) and asked ‘how it went’ even though my first appointment was far in the future.

Another issue I had with the process is that BetterHelp advertises that you also get chat/email therapy with your therapist in addition to video sessions. Supposedly, you can write them your thoughts and feelings and they will respond therapeutically. I did this, since I did not have an appointment scheduled for three weeks, but really did not get a meaningful response except ‘we will talk about that when we meet.’

Next week:

In the next installment, I will review the costs of BetterHelp (is it really cheaper than ‘real therapy’, as it purports to be?), outline some problematic issues associated with the platform, and present the reader with final questions.